QuestionQUESTION: first let me say thank you for helping people like us. Pay it forward. I was rearended by the car behind me. The car damaged my frame. My car was over 10,000 in damage so of course they totaled the car. We have already settled on that. I need help on what you think my injury claim is worth. Here is the run down. Oh there were no other car involved in the accident. and they accepted fault.
I went to the hospital and saw a chiroprator/nurologist.
I had MRI's done/missed a work
Mri report stated that
L5-S1 There are changes of mild chronic degeneration. There is a 3mm broad-based central disc protrusion with partial annular tearing without the cal sac deformity or nerve root displacement.
I missed several weeks from work. My job requires heavy lifting.
I went home the day of the accident.went to the hospital the following morning. Hospital was a joke. No xrays done there. They gave me motrin and muscle relaxer I went to a chiropractor the next day and saw them for about 30 visits. I saw a neurologists about the pain and numbess that is still going through my legs and toes and arms. The nerolgists said I was ok but should not settle my claim just yet. wait to see about the tingling and they may do a procedure called electroddermated where they stick needles in you.. I know I didnt spell that right.
My chirpractor has already released me. I feel better having gone to the chiropractor and wished I could still go. I still have pains and the shooting pain in my legs and tingling bothers me. It is not all the time but it does come and go.
I really think I need further treatment from the chiroprator.
Here are my bills
missed work 3200.00
hospital and dr bill 1,000
chiropractor 3295.00
prescriptions 275.00
Mri 1,000.00
nurologists 300.00
What do you think my claim is worth?
Thanks again,
Candi ..San Diego
ANSWER: Dear Candi,
Thank you for the kind comments regarding our work here, but maybe you will want to reserve judgment once you discover that we cannot give any information regarding the actual value of a claim.
First, the various bar associations have taken the position that such would be the practice of law in their states. Second, there never is sufficient information in this brief forum to even guess at the value: it is an art as well as a science, and there are many factors I would use to value a claim (such as your personality, personal life force, etc.) that are not available, Third, we stand the risk of a malpractice lawsuit should we make a wrong valuation and the questioner consider herself to have been damaged by our valuation estimates. Thus, we just give general information and let you go from there.
In this instance, I am going to side with your neurologist: do not settle too soon.
It seems to me that you have a very serious injury, that you are still suffering from that injury, that the injury is not susceptible to therapy (as in a ligementous injury or a broken bone), that the injury can and will constitute a significant problem in your work life and your daily life, and thus, that the injury is partially disabling.
Therefore, I would strongly advise to await further living with the injury in order to get a better picture of how it impacts your daily life over many months, AND whether or not it is getting better or worse or staying the same. This could be a semi-permanent injury, and it could also make you susceptible to further serious injury with less trauma in the future. Who is going to pay for that risk if you don’t take the time to get good medical prognosis reports now?
I will provide FIVE parts in my answers to your question.
1. First will be general comments regarding valuation, since that is what you asked about.
2. Next is my plea to TAKE CHARGE of your claim: don’t let the adjuster be the first one to put out a figure—that is a weak negotiating position.
3. Third is some detail about valuation.
4. Fourth is the MOST IMPORTANT: it is my plea to WAIT AND DO NOT FALL FOR THE INSURANCE TRICK OF PREMATURE SETTLEMENT. Live with your injury enough for it to mature so that at least you know what you are dealing with.
5. And fifth is a general hint on dealing with the adjuster.
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INTRODUCTION TO VALUATION—INSUFFICIENT INFORMATION
NO, Candi—there is never any website or any attorney or any adjuster who could provide any ballpark figures for settlement of a claim given the utter lack of information you present.
Next is low back pain and radiating pain and tingling. Two comments here: first, you will have to provide more information to the adjuster, and second, low back pain and tingling SHOULD NEVER EVER be settled so quickly, What kind of life do you lead in the summer season? What will you do when that "limited" pain becomes persistent and bothersome each day? Once you settle, that is it—there are no "do-overs" as Seinfeld would say.
Don’t take this bawling out too personally: most people have NO IDEA how to settle their own claims until they get some guidance, which I will provide below. But first, let’s look at the kind of information you provided. Your question is impossible to answer in that I have no idea about your injuries, your treatment, your prognosis, or the way in which your injuries interfered with your life.
You need to communicate how this impacts you. The insurance companies do not hand out settlement awards of any substance unless they are convinced that there is some good reason to do so. And, if you do a good job, your settlement should be substantial: I would aim over $50,000 if the disc protrusion continues to give radiating pain and tingling inasmuch as that is a potential permanent disability.
I want you to become informed about the process of personal injury insurance claims, and to have a little insight on how to proceed. You might want to consider the advantages of hiring an attorney instead of doing a self help personal injury claim.
Many people do not have the time to present their own claim. Nor do they like to get involved with negotiations with an insurance adjuster. And, of course, if their claim involves any significant legal issues, most people would prefer to hire an attorney, and we advise that they do so.
Likewise, if there are significant injuries, which will translate into significant personal injury damages, then we recommend that the claimant get professional advice or representation from a competent personal injury attorney.
Otherwise, most people with medium ($50,000) and less claims can and do settle their own claims, and they do a good job of it. I suspect that you fit into this category by the way you have presented yourself, so maybe you will try to do this yourself first.
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Take the initiative and DO NOT LET THE ADJUSTER DICTATE THE SIZE OF THE BALLPARK you are going to play in: Get your demand letter out there. Even if you are not ready to settle just yet and so your letter may have no actual monetary “demand”, at least you will get the medical records before the adjuster so he can start to build up his reserves for your claim. Since you are way too early to think of settling, just let the adjuster know you will complete the letter as time goes by. But also tell him that if his clent has policy limits of $100,000 or less, you will agree to settle for those limits (subject to the agreement of your subrogated insurance carriers). http://www.settlementcentral.com/page0451.htm Insurance Policy Limits Information.
You should be commended for having the initiative to seek out a website such as this and to ask for help, but the most important part of achieving a successful personal injury claim HAS TO START WITH YOU, NOT THE ADJUSTER. Do NOT let the adjuster set the parameters of the negotiation: get your demand letter out there once you are ready to settle. It is not all that hard or mysterious to put together an Effective Personal Injury Insurance Demand Letter http://www.settlementcentral.com/page0170.htm. It does not have to be "fancy" or complex; just hit the main points and get it out to the adjuster soon.
Use a Confidential Personal Injury Diary for TOP DOLLAR Insurance Claim Settlements http://www.settlementcentral.com/page0208.htm.
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ELEMENTS OF YOUR DAMAGES AND VALUATION TIPS
We consider the damages in three categories: special damages, general damages, and future damages (which will be both special and general).
Special damages are things that are capable of ascertainment by calculation or documentation. These include such topics as medical and chiropractic expenses, appliances (crutch or dental appliance for a jaw joint claim), physical therapy, lost wages, transportation to and from medical appointments, hired chore and personal help, and the like.
General damages are for pain and suffering, loss of enjoyment of life, severe emotional distress, and the like.
Usually general damages are the “wild card” in the settlement, and that is where the negotiation centers. Assuming that they agree to the special damages, what is left is to argue about the value of the claim for the suffering that you have and will endure.
It does sound like you could have much in the way of future damages since your condtion will continue to bother you. Thus the advice of the neurologist to wait a bit is sound. But at this stage, if you were to try to get an award for future damages, you might need a workup from your doctor just on that topic alone. Your doctor cannot just state that you will need some additional care in the future. NO, he has to make it an unambiguous statement of need: a firm prediction that you will need work treatment and state its risks and costs.
What about valuation of your claim? How does one figure out what to ask for? Answer: get as much as you can. Figure out what would make you happy, and increase that amount by at least 50%!
Valuation is not like going to a drive-in for a fast food meal. It takes time and study of many factors, including liability and medical records. The "rule of thumb" is just that: a gross estimate.
SHORT ANSWER: A common theme among those who still think a formula will put you in the valuation ballpark is to multiply the medical specials times a number from TWO to FIVE (depending upon factors, some of which I will give you later—or all of which are listed in the members' side of my website, www.SettlementCentral.Com). Then that figure is the total value of the personal injury portion of the claim. Of course there is a long list of factors to consider for adding or deducting from the total.
Let's start with geography. Values differ from state to state, and within each state. City values are often different than rural values on claims.
Next, the seriousness of the injury, and of course, whether or not the injury can be proven by objective evidence (that scar), or whether the only proof is subjective (your statements that you feel pain).
Here is a listing of factors that will affect both the multiplier you will use, as well as the value of the claim inasmuch as they will increase or decrease the product of your multiplication.
1. LIABILITY DISPUTE & comparative negligence
This is a big one because it most dramatically affects value: minus if you have any fault.
2. Trauma suffered
The value of your claim increases with a bigger crash, and decreases with a low damage fender bender. Why? Just human nature.
Therefore, the total value of the property damage (e.g. cost to repair or replace a motor vehicle) becomes significant. You have an advantage here.
3. Medical special damages
Cost of medical and related health care expenses; higher costs usually equate to an increase in value (excepting, of course, cases of gross overtreatment).
4. Type of injury
Where does the injury fall within the insurance industry's "hierarchy list" of valuing injuries? Irrespective of which injury may cause more pain, injuries are valued according to seriousness, tendency to be persistent or permanent, and whether or not they need objective proof to be believed (e.g. a broken bone versus soft tissue strain).
The MRI shows a serious injury.
5. Type of medical care
Where does the medical care fall within the insurance industry's "hierarchy list" of valuing medical care? Orthopedists at the top, chiropractors near the bottom. Neurologists are in the middle.
6. Prognosis- future care—permanency of injury or pain and suffering—this is where you need a good record from your neurologist.
Your claim value gets a boost if your doctor specifies that you will need some future medical care.
7. Your medical and claims history, prior accidents, prior injuries or treatment of the same area of the body.
8. Impairment of quality of life.
9. Quality and persistence of pain suffered.
10. Quality and thoroughness of your medical records.
11. Lost wages.
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DO NOT SETTLE YOUR CLAIM UNLESS YOU ARE ABSOLUTELY CERTAIN THAT YOUR INJURIES WILL NOT REAPPEAR ONCE YOU STRESS YOUR BODY WITH PHYSICAL ACTIVITIES. That Plays Right Into an Insurance Tactic Regarding Inducing Early Settlement of Injury Claims.
Let's just finish up this topic of early settlements so you get the full picture of the advantage to them and the risks to you. Insurance companies like to settle early because the general damages—claims for pain and suffering—are always minimal, but continue to grow with continued medical/therapeutic care over the months. Therefore, the insurance adjuster will try to settle before your claim merits a larger pain and suffering element. This makes good sense for the insurance company. A claim that is still active after 12 months, with an injured claimant still undergoing treatment, will settle for a lot more pain and suffering money than a claim that is settled after two or three weeks of treatment.
In serious disc protrusion case, which this COULD BE the full extent of most injuries is not known immediately after finishing one early round of treatment, because the injured person has to undergo some of the wear and tear of everyday life, including the pounding her body will receive from a day's work. Even jobs that appear not to be physically demanding can be hard on an injured body.
For example, have you ever stood all day with few breaks, as a store checkout clerk or a jewelry salesperson does? Or sat all day at a computer, as a secretary or phone service center employee does? Many jobs will interfere with healing, and you have no way to know how your body will respond until you have experienced sufficient physical exposure to load-test the scar tissue as you heal. Plus, what is to “heal” in a disc protrusion? Ask your doctor what will happen to make the tingling and radiating pain diminish.
Plus, who will pay for your medical care incurred AFTER you settle? What if you were to settle now and three months later when you mow the grass and the pain starts to become too much, you go to a chiropractor only to discover that you can expect a course of treatment that will cost a lot of money?
After you settle your claim, all further treatment is your responsibility. Except in specific, unusual situations, you cannot go back and re-open a settlement: when you cash the check, you agree to close your claim in all aspects. Check with your PIP adjuster to find out whether they will pay anything once you close the claim against the tortfeasor.
Here is another page from my website that shows in detail why you should never make an early personal injury insurance claims settlement http://www.settlementcentral.com/page0211.htm
And, of course, once you settle, THAT IS IT: no one will be there to pay for your future medical or chiropractic care; nor will you ever see another dime in pain and suffering money. By the way, did you know that getting an early settlement is a favorite trick of the insurance adjusters? Please see my website wherein we show Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm
There may be a dull ache at night following some physical activity or pain the next morning. DO NOT LET LITTLE PAINS GO UNATTENDED SINCE YOU DO NOT KNOW WHETHER THEY WILL CONTINUE OR GO AWAY. We all hope and believe that such little pains will disappear soon. But on the other hand, we have no way of knowing since this is the way serious soft tissue injuries can behave.
So, when this happens, even if a couple months or more post-treatment, do not hesitate to SEE A DOCTOR AND ATTRIBUTE THE PAIN TO THE ACCIDENT WITHOUT EQUIVOCATION. It is NEVER TOO LATE TO REPORT PERSONAL INJURIES FROM A CAR ACCIDENT http://www.settlementcentral.com/page0104.htm
According to Our http://www.SettlementCentral.Com Members, Chiropractors are Most Effective in Severe Whiplash and Soft Tissue Car Accident Injuries http://www.settlementcentral.com/page8010.htm
I would write BOTH your neurologist and your chiro a letter and tell them jointly what you are suffering and that you need more treatments. You know, if a chiro knows that he is dealing with a disc protrusion, he might not continue to adjust your spine in THAT area. Some people have had good luck with a qualified massage therapist.
Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.htm
"No medicine: no money"; medical costs increase worth of personal injury insurance claims http://www.settlementcentral.com/page0045.htm
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FINAL TOPIC: Effective communication with insurance claims adjusters. Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm
Always communicate with the adjuster in writing, showing your own analysis of value. It is OK I guess to have one call or so, but no more. Always have your information and ammunition in writing to give to the adjuster.
Responding to Settlement Offer From Insurance Claims Adjuster http://www.settlementcentral.com/page0244.htm
Let him know that you are FIRM IN YOUR RESOLVE to get what you are demanding (NOT "asking", since that invites a counter-offer, but instead "demanding" as fair and reasonable compensation) by asking him what the options are to resolve the matter fairly should he not agree to a reasonable claim value. In other words, let him know that you will go through with a court filing if need be.
Remember these tips, do your homework, print out your evidence, show resolve to get your fair settlement, and you will DO JUST FINE.
I trust that my extra time here has produced some information that has been of value to you, and thus I would respectfully request that you take the time to locate the FEEDBACK FORM on this site and leave some feedback for me.
Best Wishes,
Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com
---------- FOLLOW-UP ----------
QUESTION: Sorry to ask another question. Oh and I will be using your website when I get ready to settle at settlementcentral. I also told my friend and aunt about that website.
Ok here is the question. My chiropracter tells me that he has to end the session. My neurologist did the exam and says that I am fine. But that I should wait 6-8 weeks before I settle. The pain is every so often and can be only for a few seconds but painful. Now if this pain continues He wanted me to do a painful procedure by sticking needles into me. But it appears to me that there is really no quick fix for this nerve type problem. I am not one to have surgery and tests that are extremley painful unless there is no other solution. I hate needles. I am living with this pain as it is not everyday and when it comes it is gone within a few seconds never really over a minute. So my question is that if the pain continues on and I don't want to go through all the crazy procedures that will probably not help... how will this affect my claim?
And is my injury considered a serious injury or something they will laugh at.
Thanks again..
AnswerHello again, Candi,
Thank you for the kind comments regarding my work and our site for self help personal injury insurance claim settlements: www.settlementcentral.com
As for this question, never apologize for asking again inasmuch as that is what we are here to do. We like to help people like you.
Now, let me just have you answer your last question about a serious injury or not by re-reading very carefully all that I wrote for you above. A number of times I mentioned the serious nature of the injury, the possibility of partial disability, and the probability that this injury WILL be noticed in future years.
If you elect not to take a course of action that will reduce your pain, then your claim will suffer in value. Look at it this way: if you truly hurt, you will take the action. If you elect not to take the action, then you do not truly hurt.
THAT is how the insurance adjuster will see it. I have had clients take all kinds of cures that supposedly were scary or hurt, such as the needles. But never did they complain afterward. EVERY TIME THEY WERE HAPPY THAT THEY FOLLOWED DOCTOR'S ORDERS. My advice: take the needles first and see what they do. Wait a long time before any surgery.
Let me go back to your question once again and give you a legal reason why your claim will lose value. A claimant has the duty to mitigate her damages. That means that she has to take all necessary actions, especially if recommended by her doctor that are designed to reduce damages.
Thus, if you elect to forego a simple procedure that the doctor says will help you, any complaints of pain thereafter should not be compensated. Hence, your claim will lose value. Does that make sense?
I want you to read up on the policy limits so that you can ask about that topic. Or, I should say, so that you can offer to accept the limits, as I mentioned above.
You may find that the tortfeasor has no problem revealing the limits. But most adjusters think that protecting the limits amount is somehow necessary to a good negotiation. That is not true, but the point is: sometimes it is difficult to get them to reveal the limits. Hence the recommendation that you offer to settle for any limits they have. (That is: presuming that you do have your own underinsured motorist (UIM) coverage)
Best wishes,
Dr. Settlement, J.D. (Juris Doctor)
www.SettlementCentral.Com
Mri report stated that
L5-S1 There are changes of mild chronic degeneration. There is a 3mm broad-based central disc protrusion with partial annular tearing without the cal sac deformity or nerve root displacement.
